Bangladesh nationals: WASH Consultant (Strengthen Arsenicosis Prevention, Surveillance and Management)
Purpose of Activity/Assignment:
The WHO/UNICEF Joint Monitoring Programme 2017 report indicates that in Bangladesh although 98% of the population has access to improved water sources in Bangladesh, only 56% use safe drinking water (i.e. water that complies with the Bangladesh standards for arsenic and microbiological contamination). The most recent Multiple Indicator Cluster survey noted that 19.7 million people in Bangladesh are exposed to arsenic through exposure to concentrations of arsenic in drinking water sources above the Government of Bangladesh standards (0.05mg/l) and double that number are exposed to drinking water sources which are above the WHO guidelines (0.01mg/l) with long term and short-term implications for the country.
Exposure to arsenic may result in arsenicosis which has implications for the general population including women and children. There is epidemiological evidence that exposure to elevated levels of arsenic in drinking water is also related to higher rates of spontaneous abortionand neonatal death. Arsenic exposure during pregnancy has also been associated with lower birth weight mediated mainly through decreased gestational age contributing to the reasons why Bangladesh is amongst the top ten countries in the world with the highest preterm birth rates (i.e. <37 weeks of gestation). Exposure to arsenic in the drinking water has also been associated with an increased occurrence and/or severity of lung disease, cardiovascular disease, and cancer in childhood. In summary, Arsenicosis has short and long term health, social and economic implications for Bangladesh which include life threatening cancers, social stigmatization of women and linkages to poor cognitive development of children.
Though the Arsenic Mitigation Policy stipulates that ‘all arsenicosis cases shall be diagnosed and brought under an effective management system’, most of the people suffering from the effects of exposure to arsenic are neither diagnosed nor adequately managed. In some cases, the absence of skin lesions in people exposed to arsenic contamination reduces the perception of the risk and the associated success of behavior change interventions. In most cases in Bangladesh, the identification and management of arsenicosis patients is disconnected from the management of arsenic drinking water safety risks with insufficient collaboration between the statutory sectors responsible for safe drinking water provision and responsible for health. There is a need to bridge this gap and facilitate the prevention, identification, reporting and management of arsenicosis within the context of both health and drinking water provision.
The SIDA supported project ‘Strengthening Systems for scaling up Drinking Water Safety in Bangladesh’ under GoB-UNICEF WASH project (2017 to 2021) aims to bridge this gap by linking the management of exposure to arsenic through the safe drinking water provision in the DPHE-UNICEF Arsenic Safe Union Approach by extending the arsenicosis patient management system within these unions. This will involve the review, development and roll out of harmonised tools and training package for arsenicosis case detection, monitoring, reporting and management.
Various discussions have been held with the statutory government departments responsible for safe water provision and arsenicosis management including sector partners such as WHO and there was consensus that WASH and Arsenicosis is a priority and relevant to the operational plans of the government departments. Consequently, a multi-stakeholder Technical Committee ‘ Strengthen Systems for Detecting, Managing and Reporting Arsenicosis’ was set up under the leadership of the of the Line Director , Non-Communicable Disease Control Programme (NCDC).
The Technical Committee requested UNICEF to hire a consultant during the stakeholder meeting held on the 2nd of April, 2019. The purpose of this consultancy assignment is to provide technical support to the NCDC and DPHE and the Technical Committee for the review, development, harmonisation and roll out of of arsenicosis case detection, monitoring, reporting and management package. The consultant is also expected to build on the management of exposure to arsenic through the DPHE-UNICE Arsenic Safe Union Approach by extending the arsenicosis patient management system within these unions.
Under this assignment, some of the expected tasks include:
- Working closely with NCDC of DGHS, WHO and the technical committee prepare an integrated workplan and identify relevant aspects of the operational plans ( of NCDC, MIS, CBHCC, Nutrition, MIS and DPHE) to review and operationalize arsenicosis management protocol .
- Conduct a situational analysis using desk review, key informant interviews and stakeholder consultations to assess the status of arsenicosis management and reporting and linkages with water supply and nutrition in Bangladesh and globally.
- Review and update and harmonise case management tools for all levels of care (detection, management, referral, monitoring and reporting
- Review and update existing IEC materials for production by printing company.
- Review and harmonize training package for arsenicosis detection, monitoring and management
- Provide TOT on harmonized case management and reporting package in 9 districts and 16 health complex including the UNICEF WASH and SDIA supported areas
- Facilitate step down training (500 staff of health clinics) within the UNICEF WASH and SIDA supported areas
- Support the roll out of the guidelines and the implementation of case detection, case management and monitoring tools in selected SIDA supported Upazilas
- Facilitate the linkage and integration of arsenicosis reporting in health and WASH monitoring and reporting tools/MIS.
- Compile periodic and end of assignment reports to UNICEF and NCDC, DGHS in relation to the key tasks
- Integrated Workplan (operational plans of Govt. and UNICEF)
- situational analysis report and stakeholder mapping (Desk Review, key informant interviews and one stakeholder consultation workshop report) of case detection, management and arsenic mitigation in Bangladesh and produce situation report
- updated case management and IEC tools for all levels of arsenicosis care (detection, management, referral, monitoring and reporting and one stakeholder workshop report
- Training plan and harmonized training package for arsenicosis care (detection, management, referral, monitoring and reporting)
- 4 TOT training (1 at National) and 3 at Sub-national levels delivered in the SIDA operational areas to DGHS medical officers, nurses, other health care staff and NGO staffs on harmonized case management and reporting package in 9 districts and 16 health complex including the UNICEF WASH and SDIA supported areas and reports are available
- Step down training (500 staff of health clinics) within the UNICEF WASH and SIDA supported areas through master trainers facilitated and reports available and roll out of the guidelines and the implementation of case detection, case management and monitoring tools in selected SIDA supported Upazilas finalized.
- Arsenicosis data is collected in monitoring and reprint formats and updated in the arsenicosis patient registry
- Provide monthly reports and end of assignment reports to UNICEF and NCDC, DGHS relation to the key tasks
- Having a Bachelor of Medicine with master’s degree of Public health, Master of Medicine to WASH related development assistance.
- At least 8 years’ experience in development field, preferably in the Public Health, special focus on arsenicosis research and evidence generation;
- Familiarity with existing training and management protocols of arsenicosis within the local and global context
- Extensive experience in organizing and facilitating training/meeting/workshop/seminar;
- Past collaboration with DGHS and research institutions on arsenicosis
- Excellent report writing skills.
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UNICEF is committed to diversity and inclusion within its workforce, and encourages all candidates, irrespective of gender, nationality, religious and ethnic backgrounds, including persons living with disabilities, to apply to become a part of the organization.
UNICEF has a zero-tolerance policy on conduct that is incompatible with the aims and objectives of the United Nations and UNICEF, including sexual exploitation and abuse, sexual harassment, abuse of authority and discrimination. UNICEF also adheres to strict child safeguarding principles. All selected candidates will, therefore, undergo rigorous reference and background checks, and will be expected to adhere to these standards and principles.
- Only shortlisted candidates will be contacted and advance to the next stage of the selection process.
- Duration: 6 months
- Duty Station: Dhaka